A randomised comparison of UK genetic risk counselling services for familial cancer: psychosocial outcomes.
A randomised comparison of UK genetic risk counselling services for familial cancer: psychosocial outcomes.
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DOI：
10.1038/sj.bjc.6602081
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发表时间：
2004-08-31
影响因子：
8.8
通讯作者：
McPherson, K
中科院分区：
文献类型：
--
作者：
Hopwood, P;Wonderling, D;Watson, M;Cull, A;Douglas, F;Cole, T;Eccles, D;Gray, J;Murday, V;Steel, M;Burn, J;McPherson, K
该研究的目的是比较 50 名新诊所就诊者的心理社会结果，他们被转介到英国五个中心接受癌症遗传咨询。这些中心代表英格兰、苏格兰和威尔士，是从根据癌症遗传学实践中不同临床活动水平排名的小组中随机选出的。问卷评估了咨询前以及 1 个月和 12 个月随访时的人口数据、风险认知、心理健康和卫生服务的使用情况。在随访中测量了参加者和转诊医生的满意度。共有 256 名未受影响的成年人符合研究标准。这五个中心在服务组织和活动方面差异很大，但所有未受影响的参加者中患有乳腺癌风险 (61-91%) 的比例都高于肠癌风险 (0-33%) 或卵巢癌风险 (3-25%)。各中心预咨询的社会心理数据没有显着差异。随着时间的推移，任何一个中心的风险认知或一般心理困扰都没有发生显着变化。各中心在从基线到 12 个月的癌症担忧减少方面存在显着差异，并且在建议进行乳房 X 线摄影监测但未接受此项监测的女性数量方面存在显着差异。总体而言，三分之一被建议进行乳房X光检查的女性在随访一年内没有接受筛查。随后去看全科医生（但不去医院）与风险水平相关，但无法分析中心之间的差异。各中心对服务提供的 4 : 14 项和与沟通有关的 3 : 17 项的满意度存在显着差异；总体满意度较高。超过 90% 的转诊医生对服务表示中等/非常满意，但 23% 对等待时间不满意，19% 对获得预防性治疗不满意。各中心之间的医生对转诊标准和处方信息的满意度的结果存在显着差异。总之，考虑到服务组织和活动的巨大差异，各中心之间的心理社会结果差异相对较小。这些显着差异在各中心之间并不一致，因此，差异不能与服务提供的具体方面联系起来。
The aim of the study was to compare psychosocial outcomes for 50 new clinic attendees, referred for cancer genetic counselling to five UK centres. The centres represented England, Scotland and Wales, and were randomly selected from groups ranked by different levels of clinical activity in cancer genetics practice. Questionnaires assessed demographic data, risk perception, mental health and use of health services pre-consultation and at 1 and 12 months follow-up. Satisfaction was measured for attendees and referring doctors at follow-up. A total of 256 unaffected adults fulfilled the study criteria. The five centres varied widely with respect to service organisation and activity, but all had a greater proportion of unaffected attendees with a breast cancer risk (61–91%) than either a bowel cancer risk (0–33%) or ovarian cancer risk (3–25%). There were no significant differences in the psychosocial data between centres pre-counselling. No significant change over time occurred for any of the centres for risk perception or general psychological distress. There were significant differences between centres in reduction of cancer worry from baseline to 12 months and with the number of women who were recommended to have mammographic surveillance who had not received this. Overall, one-third of women for whom mammography had been recommended had not been screened within 1 year of follow-up. Subsequent attendance at the GP, but not at a hospital, was associated with risk level, but differences between centres could not be analysed. Satisfaction differed significantly between centres for 4 : 14 aspects of service provision and with 3 : 17 items concerning communication; satisfaction was high overall. Over 90% of referring doctors were moderately/very satisfied with the service, but 23% were dissatisfied with waiting times and 19% with access to preventive treatment. Results differed significantly between centres for doctor's satisfaction with the provision of referral criteria and prescribing information. In conclusion, there were relatively few significant differences in psychosocial outcomes between centres, considering the wide variation in service organisation and activity. These significant differences were not consistent across the centres, therefore, differences could not be linked to specific aspects of service provision.
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影响因子：
8.4
作者：
MURDAY, V
通讯作者：
MURDAY, V
影响因子：
158.5
作者：
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